Objective: The purpose of this study was to examine the influence of patient and caregiver characteristics on caregiver subjective and objective burden and caregiver mental and physical health in family caregivers of patients with ESRD. Design: A cross-sectional, descriptive correlational design was used to study caregivers of patients diagnosed with ESRD. Sample/Setting: Data were obtained from a convenience sample of 120 caregivers recruited from three private, physician-owned dialysis centers located in the Mid-South. Concepts/Variables: Subjective burden refers to the emotional costs and the caregiver's attitude toward caregiving whereas objective burden reflects the extent of disruptions or changes in the caregiver's life such as decreased finances and loss of employment. Mental health pertains to depressive symptomatology such as a depressed mood in the caregiver and physical health pertains to bodily or physiological changes that occur in the body resulting in poor physical health. Within the Pearlin stress model, these outcome variables along with patient and caregiver background characteristics provided the foundation for developing a conceptual model of caregiving within the context of ESRD for this study. Methods: Caregivers who attended dialysis appointment with the patient were recruited for the study. Patients were given questionnaire packets to give to their family caregiver who was not present during the patient's dialysis appointment. Data were collected using a demographic data form and the Measurement of Burden Scale(MBS)to assess subjective and objective burden. The Center for epidemiologic Depression Scale(CES-D) and a single-item, self-rated health question were used to assess depressive symptoms and caregivers perceptions of their own physical health and the patient's physical health, respectively. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, and multiple regression using stepwise regression with backward elimination. Findings: Thirty two percent of the variance in adjusted subjective burden scores was explained by the caregiver perceptions of the patients health (B=.055,p=.0029), caregiver education (B=-.012,p=.0026), patient age (B=-.002,p=.0376), and caregiver support (B=.293,p=<.001),whereas (39%) of the variance in adjusted objective burden scores was explained by caregiver perceptions of the patients health (B=2.77,p=<.0001), caregiver education (B=.03,p=.0348), caregiver relation to patient (B=3.01,p=.0007), hours of care (B=2.15,p=.0123), and caregiver support (B=4.69,p=.0544). Four statistically significant predictor variables (caregiver perceptions of the patient health (B=.12,p=.0427), caregiver age (B=-.01,p=.0014), patient diabetes (B=.16,p=.0476), caregiver support (B=.70,p=.0030) explained (28%) of the variance in adjusted depressive symptom scores. Eighteen percent of the variance in adjusted physical health scores was explained by caregiver perceptions of the patient health (B=.06,p=.0010) and caregiver age (B=.002,p=.0458). Conclusions: Multiple regression analysis revealed that the caregivers' perception of the patients' health was a consistent and significant predictor of caregiver (mental and physical) and burden (objective and subjective). Also, the caregivers' perception of family support was retained in 3 of the 4 models. Several of the predictor variables are not amenable to intervention (i.e., caregiver age), but this information may help to identify caregivers who are at greatest risks for significant burden and poor health outcomes. Implications: The findings from this study may be helpful to health professionals who assist family caregivers in planning care for the patient receiving dialysis. Developing interventions that enhance the psychosocial well-being and promote caregivers' health might help to alleviate caregiver burden, depressive symptoms, and deterioration in physical health associated with the caregiving role.
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